Category Item #1 as excerpt, Items #2-5 as title only?

I’d like to organize my page such that categories display the full “the_excerpt()” of the first entry in a category followed by items 2 through 5 as “also in this category” style.

Anyone know how to accomplish this? If I try a loop, it shows all five. If I try two separate loops, Item #1 shows up in the list even though it’s already on the page.

thanks!